Therapy101 / Relationships
Family and systemic work
Systemic therapy considers relationships and interactions. It can involve individuals, couples, families or wider networks.
Systemic perspectives
Systemic approaches consider relationships, patterns of interaction and the meanings people give to them. Rather than locating a difficulty solely inside one family member, systemic practitioners ask how family members respond to one another and how wider social and cultural contexts shape the situation. A therapist may work with an individual, a couple, a family or a wider network; the approach is not limited to sessions with every family member present.
Who takes part
Family therapy can take different forms. The people invited and the number of meetings depend on the service, the people involved and their aims. For example, one NHS family therapy service describes meetings with some or all family members, as well as individual and couple appointments. People should not feel pressured to take part.
Traditions within family therapy
Early schools in the 1950s to 1970s included structural family therapy (associated with Salvador Minuchin), Bowenian multigenerational work (Murray Bowen), experiential work (Virginia Satir), strategic therapy (Jay Haley) and the Milan systemic approach (Mara Selvini Palazzoli and colleagues). Later developments included solution-focused and narrative therapies, which pay close attention to language, stories and how a family describes a problem.
A constructed example
Constructed for learning. Not a real case.
A parent and teenage son attend a family therapy appointment after months of arguments at meal times. The practitioner invites each of them to describe what a typical evening looks like and asks Circular questions such as: ‘When the two of you start arguing, what does your younger daughter usually do?’ The conversation shifts from blaming one person to noticing a pattern that everyone in the household is caught in.
Limits and open questions
Feminist and cultural critics noted that early systemic models sometimes treated all participants as having equal power in a family system, overlooking gender, generational hierarchy, cultural norms and abuse. Joint family sessions are not appropriate where there is ongoing violence or intimidation.
Sources and inspection notes
British Association for Counselling and Psychotherapy. What is systemic therapy?
Supports: The focus on relationships and interactions and the inclusion of couples, families and other groups.
Association for Family and Systemic Psychotherapy. (2025). Code of Ethics and Practice.
Supports: The UK professional body describes systemic work with individuals, couples, families and other relationship networks; its code gives a UK professional context.
Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust. Family Therapy: information leaflet.
Supports: One NHS service describes variable participation, individual and couple appointments, and not pressuring people to attend; arrangements can differ elsewhere.